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How Do You Diagnose Gestational Diabetes

Gestational Diabetes

Gestational Diabetes

Gestational diabetes definition and facts Risk factors for gestational diabetes include a history of gestational diabetes in a previous pregnancy, There are typically no noticeable signs or symptoms associated with gestational diabetes. Gestational diabetes can cause the fetus to be larger than normal. Delivery of the baby may be more complicated as a result. The baby is also at risk for developing low blood glucose (hypoglycemia) immediately after birth. Following a nutrition plan is the typical treatment for gestational diabetes. Maintaining a healthy weight and following a healthy eating plan may be able to help prevent or minimize the risks of gestational diabetes. Women with gestational diabetes have an increased risk of developing type 2 diabetes after the pregnancy What is gestational diabetes? Gestational diabetes is diabetes, or high blood sugar levels, that develops during pregnancy. It occurs in about 4% of all pregnancies. It is usually diagnosed in the later stages of pregnancy and often occurs in women who have no prior history of diabetes. What causes gestational diabetes? Gestational diabetes is thought to arise because the many changes, hormonal and otherwise, that occur in the body during pregnancy predispose some women to become resistant to insulin. Insulin is a hormone made by specialized cells in the pancreas that allows the body to effectively metabolize glucose for later usage as fuel (energy). When levels of insulin are low, or the body cannot effectively use insulin (i.e., insulin resistance), blood glucose levels rise. What are the screening guidelines for gestational diabetes? All pregnant women should be screened for gestational diabetes during their pregnancy. Most pregnant women are tested between the 24th and 28th weeks of pregnancy (see Continue reading >>

Gestational Diabetes Testing: Which Method Is Best?

Gestational Diabetes Testing: Which Method Is Best?

Home / Preg-U / Health / Gestational Diabetes Testing: Which Method is Best? Gestational Diabetes Testing: Which Method is Best? The glucose tolerance test for gestational diabetes is something of a second trimester rite of passage. If your pregnancy has proceeded uneventfully so far, nearly all the standard tests are behind you. Only one standard test left. And for this final one (typically between 24-28 weeks), you get to choke down a disgustingly sweet drink* (think cough syrup without the bitter aftertaste) and have your blood drawn repeatedly. Sounds fun, right? Two major methods of screening women for gestational diabetes exist: The two step method and the one step method. Interestingly, these are not equivalent. Which test you receives can have a big impact on whether or not you are diagnosed with gestational diabetes. Most providers in the U.S. use the two-step method. This results in 7-9% of pregnant women in the U.S. being diagnosed with gestational diabetes each year. If all these providers were to switch to the one-step method, the percentage of women diagnosed would double to 18% of all pregnant women according to the American College of Obstetricians and Gynecologists . Does this represent a potential overdiagnosis or current underdiagnosis? Before we dig into this question, lets back up for a minute to define the tests. Why do we need to test all pregnant women for gestational diabetes? Well, for starters, blame the placentathe organ that connects your baby to your blood supplythe biggest culprit behind the question what causes gestational diabetes? Our bodies rely on a hormone called insulin to move glucose (sugar) from our blood into our cells, where it can be used for energy. Early in pregnancy, women begin producing more insulin. Then, around 20 week Continue reading >>

Gestational Diabetes And The Glucola Test

Gestational Diabetes And The Glucola Test

June 14, 2012 by Rebecca Dekker, PhD, RN, APRN © Copyright Evidence Based Birth®. Please see disclaimer and terms of use. In the comment sections of one of my first posts, I received this question from a reader named Lela: “I would like to know more about what routine tests are actually necessary. The one that particularly caught my interest is the gestational diabetes test. The American Diabetes Association presents a list of low risk women who should not need the glucose test , even though I fit all those categories, my physician’s office still insists I take it. Is the glucose test truly the only way to catch gestational diabetes? Am I really risking both the health of me and my baby if I declined?” **This post was written before the 2013 NIH Consensus conference on “Diagnosing Gestational Diabetes.” Since then there has been new evidence published on this topic. To read updated, in-depth information about the glucola test and screening for gestational diabetes, you can read these blog articles about the conference: Day 1 and Day 2.** This article has taken me quite a bit of time to write for several reasons. First, gestational diabetes is a very complex and controversial topic. Second, there is a ton of research that has happened in the last 10 years, and it took me a long time to read the literature. Third, my readership has really taken off in the past few weeks, and I want to make sure that my posts are of the highest quality. Fourth, my kids have had a bad virus and I was very sleep-deprived this week. It was hard for my brain to function well and critically think about this issue on so little sleep, until now. With that being said, here is my best shot at an evidence-based article on gestational diabetes and the glucola test. I tried to remain as un Continue reading >>

Gestational Diabetes Test: What To Expect

Gestational Diabetes Test: What To Expect

Gestational diabetes occurs only during pregnancy, and it usually goes away once you’ve delivered your baby. Pregnant women with gestational diabetes have higher than normal blood sugar. This is because their bodies aren’t producing enough insulin. Insulin is a hormone that regulates blood sugar. Gestational diabetes can happen at almost any time during pregnancy, but it typically occurs between 24 to 28 weeks. This is also when testing typically takes place. Getting tested for gestational diabetes is an important part of prenatal care. Doctors test all pregnant women at least once during pregnancy. Your doctor will consider your risk factors when determining when you should have this test and how often you should have it. Learn what to expect during this test and how to prepare. Many women who have gestational diabetes have no symptoms. If symptoms do appear, it’s possible you may overlook them because they’re similar to typical pregnancy symptoms. These symptoms may include: frequent urination extreme thirst fatigue snoring You should call your doctor if you’re experiencing these symptoms to a greater degree than is normal for you. The exact cause of gestational diabetes is unknown, but it may be due to hormones your placenta produces. These hormones help your baby grow, but they can also stop insulin from doing its job. If your body can’t make enough insulin, the sugar in your bloodstream stays put. The sugar is then unable to convert into energy in the cell. This is called insulin resistance. If it’s left untreated, gestational diabetes can have significant consequences for both you and your baby. Once your doctor knows you have this condition, they’ll work with you on a treatment plan to ensure your and your baby’s health. Any pregnant woman can g Continue reading >>

Who Recommendation On The Diagnosis Of Gestational Diabetes In Pregnancy

Who Recommendation On The Diagnosis Of Gestational Diabetes In Pregnancy

Home > RHL Topics > Preconception, pregnancy, childbirth and postpartum care > Antenatal care > WHO recommendation on the diagnosis of gestational diabetes in pregnancy WHO recommendation on the diagnosis of gestational diabetes in pregnancy WHO recommendation on the diagnosis of gestational diabetes in pregnancy Hyperglycaemia first detected at any time during pregnancy should be classified as either gestational diabetes mellitus (GDM) or diabetes mellitus in pregnancy, according to WHO criteria. This recommendation has been integrated from the 2013 WHO publication Diagnostic criteria and classification of hyperglycaemia first detected in pregnancy (the strength of the recommendation and the quality of the evidence were not stated) (1), which states that GDM should be diagnosed at any time in pregnancy if one or more of the following criteria are met: fasting plasma glucose 5.16.9 mmol/L (92125 mg/dL) 1-hour plasma glucose 10.0 mmol/L (180 mg/dL) following a 75 g oral glucose load 2-hour plasma glucose 8.511.0 mmol/L (153199 mg/dL) following a 75 g oral glucose load Diabetes mellitus in pregnancy should be diagnosed if one or more of the following criteria are met: fasting plasma glucose 7.0 mmol/L (126 mg/dL) 2-hour plasma glucose 11.1 mmol/L (200 mg/dL) following a 75 g oral glucose load random plasma glucose 11.1 mmol/L (200 mg/dL) in the presence of diabetes symptoms. WHO currently does not have a recommendation on whether or how to screen for GDM, and screening strategies for GDM are considered a priority area for research, particularly in LMICs. Diabetes mellitus in pregnancy differs from GDM in that the hyperglycaemia is more severe and does not resolve after pregnancy as it does with GDM. A systematic review of cohort studies shows that women with hyperglycaem Continue reading >>

Gestational Diabetes

Gestational Diabetes

What is gestational diabetes? Gestational diabetes is a type of diabetes that happens during pregnancy. Unlike type 1 diabetes, gestational diabetes is not caused by having too little insulin. Instead a hormone made by your placenta keeps your body from using the insulin as it should. This is called insulin resistance. Blood sugar (glucose) then builds up in your blood instead of being absorbed by the cells in your body. The symptoms of gestational diabetes usually go away after delivery. But sometimes they do not, or you may have a greater risk of developing type 2 diabetes later. What causes gestational diabetes? Healthcare providers do not know what causes gestational diabetes, but they do know what happens. The placenta gives your growing baby nutrients and water. The placenta also makes several hormones to keep the pregnancy healthy. These hormones include: Estrogen Progesterone Cortisol Human placental lactogen These hormones can affect how your body uses insulin (contra-insulin effect). This usually begins about 20 to 24 weeks into your pregnancy and could lead to gestational diabetes. During pregnancy, more fat is stored in your body, you take in more calories, and you may get less exercise. All of these things can make your blood sugar (glucose) levels higher than normal and possibly lead to gestational diabetes. As the placenta grows, it makes more of the hormones. The risk for insulin resistance becomes greater. Normally your pancreas is able to make more insulin to overcome insulin resistance. But if it cannot make enough to overcome the effects of the placenta’s hormones, you can develop gestational diabetes. Who is at risk for gestational diabetes? Any woman can develop gestational diabetes during pregnancy. But you may be more likely to get it if you: A Continue reading >>

Pregnancy And Gestational Diabetes Screening

Pregnancy And Gestational Diabetes Screening

All pregnant women should be screened for gestational diabetes during their pregnancy. Screening may be done by taking the woman's medical history and examining certain risk factors, but an oral glucose tolerance test is also recommended. The oral glucose tolerance test is used to screen for gestational diabetes. Gestational diabetes is a specific type of diabetes that can develop in some women late in pregnancy (usually after the 24th week). Women who develop this complication do not have diabetes before becoming pregnant. The test is generally given between the 24th and 28th week of pregnancy. If you have had gestational diabetes before, or if your health care provider is concerned about your risk of developing gestational diabetes, the test may be performed before the 13th week of pregnancy. The oral glucose tolerance test involves quickly drinking a sweetened liquid (called Glucola), which contains 50g of glucose. The body absorbs this glucose rapidly, causing blood glucose levels to rise within 30 to 60 minutes. A blood sample will be taken from a vein in your arm about 60 minutes after drinking the solution. The blood test measures how the glucose solution was metabolized (processed by the body). A blood glucose level of 140mg/dL or higher will identify 80% of women with gestational diabetes. When that cutoff is lowered to 130mg/dL, the identification increases to 90%. If your blood glucose level was greater than 130 mg/dL, your provider will likely recommend you take another diabetes screening test that requires you to fast (not eat anything) before the test. During this second test, called the 100-gram oral glucose tolerance test, your blood glucose level will be tested four times during a three-hour period after drinking the sweetened (many flavors are availabl Continue reading >>

Testing For Gestational Diabetes

Testing For Gestational Diabetes

Your ‘booking appointment’ is your first appointment with your midwife or GP to talk about your pregnancy. This usually happens around 8–12 weeks of pregnancy. During that appointment, the midwife or GP will carry out some routine tests (tests offered to every woman) and ask lots of questions. Some of the questions will help find out if you are at risk of developing gestational diabetes (they will be looking to see if you have any of the risk factors). If you are considered at high risk, you will be offered a test. Agreeing to these tests is important because if you have gestational diabetes, there is a small increased risk of serious birth complications. Finding out if you have it and treating the condition can reduce those risks. The key things you need to know are: If you are at risk of gestational diabetes but don’t take the test, it can’t be found and treated. This may increase the risk to you and your baby. If you are diagnosed with gestational diabetes, you will have more check-ups and extra care during your pregnancy and labour. In some women, gestational diabetes responds to changes in diet and exercise, while others will need to take medication, which may be in the form of tablets or insulin injections. "I wasn’t obviously skinny, but I wasn’t massively obese either… I had no symptoms whatsoever. I had no expectation that the Lucozade test would be anything other than a formality." What if I had gestational diabetes in an earlier pregnancy? If you have had gestational diabetes in a previous pregnancy, you need to take action before you become pregnant again. You need to be scanned for diabetes when you are planning your pregnancy to make sure that your blood glucose levels are safe. You also need to be tested as soon as possible after your book Continue reading >>

Gestational Diabetes Exams And Tests

Gestational Diabetes Exams And Tests

XIAFLEX® is a prescription medicine used to treat adults with Dupuytren's contracture when a "cord" can be felt. It is not known if XIAFLEX® is safe and effective in children under the age of 18. Do not receive XIAFLEX® if you have had an allergic reaction to collagenase clostridium histolyticum or any of the ingredients in XIAFLEX®, or to any other collagenase product. See the end of the Medication Guide for a complete list of ingredients in XIAFLEX®. Tendon rupture or ligament damage. Receiving an injection of XIAFLEX® may cause damage to a tendon or ligament in your hand and cause it to break or weaken. This could require surgery to fix the damaged tendon or ligament. Call your healthcare provider right away if you have trouble bending your injected finger (towards the wrist) after the swelling goes down or you have problems using your treated hand after your follow-up visit Nerve injury or other serious injury of the hand. Call your healthcare provider right away if you get numbness, tingling, increased pain, or tears in the skin (laceration) in your treated finger or hand after your injection or after your follow-up visit Hypersensitivity reactions, including anaphylaxis. Severe allergic reactions can happen in people who receive XIAFLEX® because it contains foreign proteins. Call your healthcare provider right away if you have any of these symptoms of an allergic reaction after an injection of XIAFLEX®: hives swollen face breathing trouble chest pain low blood pressure dizziness or fainting Increased chance of bleeding. Bleeding or bruising at the injection site can happen in people who receive XIAFLEX®. Talk to your healthcare provider if you have a problem with your blood clotting. XIAFLEX® may not be right for you. Before receiving XIAFLEX®, tell you Continue reading >>

Gestational Diabetes Treatment

Gestational Diabetes Treatment

If youre approaching the midpoint of your pregnancy, chances are youve heard about the gestational diabetes test (a.k.a. glucose test) every pregnant woman gets. Before you schedule your appointment and head off to the lab, heres what you need to know about gestational diabetes testingplus a little extra info because we know you want to know it all. Gestational diabetes is a condition where a pregnant womans body cant properly regulate the level of glucose (sugar) in her blood, so it gets unhealthily high. This is mainly due to the hormones and weight gain of pregnancy and should go away after mom delivers (phew). But gestational diabetes is important to detect, since it can lead to complications for mom and baby, including high birth weight, preterm birth and health problems later in life. And the CDC estimates that 2% to 10% of pregnant woman develop gestational diabetes. Thats why every pregnant woman gets a gestational diabetes test around 24 weeks pregnant to 28 weeks pregnant sooner if you have history of diabetes in your family or youve been diagnosed as prediabetic in the past. There are two main gestational diabetes tests given during pregnancy: the glucose challenge test and the glucose tolerance test. Youll definitely get one but may end up getting both. Heres the scoop: Glucose Challenge Test: The glucose challenge test is a screening test, meaning it tells doctors if you have signs of gestational diabetes. For this 1-hour glucose test, youll drink a sweet Gatorade-like drink called glucola, then wait an hour (bring reading material) and have your blood drawn. If your blood sugar level is high, it can be a sign of gestational diabetes, so youll likely get a follow-up test. Glucose Tolerance Test: The glucose tolerance test is the follow-up test that can dia Continue reading >>

Gestational Diabetes

Gestational Diabetes

Home / Pregnancy Complications / Gestational Diabetes All expectant mothers will be tested for gestational diabetes atsome point during their pregnancy. Expecting mothers who are overthe age of 35, over weight, or have a family history of diabetes maybe tested earlier and more frequently. Get our Free American Pregnancy Association app: iOS Android . It features meal recommendations, kick counter, blood glucose tracking, and more. Gestational diabetes is a temporary (in most cases) form of diabetesin which the body does not produce adequate amounts of insulin to regulate sugar during pregnancy. It may also be called glucose intoleranceor carbohydrate intolerance. Sugar in urine (revealed in a test done inyour doctors office) Frequent vaginal, bladder, andskin infections Who gets gestational diabetes, and why do I have to be tested? Approximately 2-5% of pregnant women develop gestationaldiabetes; this number may increase to 7-9% of mothers who are more likely to have risk factors. The screeningfor this disease usually takes place between your 24thand 28th week of pregnancy . Doctors test for gestational diabetesduring this time because the placenta is producing large amounts ofhormones that may cause insulin resistance. If the results indicate elevated levels, further testing would be done to confirm a gestational diabetes diagnosis. During your prenatal visit, your doctor will give you a sweet (but not necessarily tasty) liquid to drink one hour before yourblood is drawn. It may cause you to feel a bit nauseous. The resultswill indicate if you are producing enough insulin or not. If I have gestational diabetes how will I be treated? The primary means of treating gestational diabetes is controllingyour blood sugar levels. There are steps you and your doctor can take in Continue reading >>

Tests & Diagnosis For Gestational Diabetes

Tests & Diagnosis For Gestational Diabetes

When will I be tested for gestational diabetes? Testing for gestational diabetes usually occurs between 24 and 28 weeks of pregnancy. If you have an increased chance of developing gestational diabetes, your doctor may test for diabetes during the first visit after you become pregnant. How do doctors diagnose gestational diabetes? Doctors use blood tests to diagnose gestational diabetes. You may have the glucose challenge test, the oral glucose tolerance test, or both. These tests show how well your body uses glucose. Glucose Challenge Test You may have the glucose challenge test first. Another name for this blood test is the glucose screening test. In this test, a health care professional will draw your blood 1 hour after you drink a sweet liquid containing glucose. You do not need to fast for this test. Fasting means having nothing to eat or drink except water. If your blood glucose is too high—140 or more—you may need to return for an oral glucose tolerance test while fasting. If your blood glucose is 200 or more, you may have type 2 diabetes. Oral Glucose Tolerance Test (OGTT) The OGTT measures blood glucose after you fast for at least 8 hours. First, a health care professional will draw your blood. Then you will drink the liquid containing glucose. You will need your blood drawn every hour for 2 to 3 hours for a doctor to diagnose gestational diabetes. High blood glucose levels at any two or more blood test times—fasting, 1 hour, 2 hours, or 3 hours—mean you have gestational diabetes. Your health care team will explain what your OGTT results mean. Your health care professional may recommend an OGTT without first having the glucose challenge test. Continue reading >>

Diagnosis And Management Of Gestational Diabetes Mellitus

Diagnosis And Management Of Gestational Diabetes Mellitus

Gestational diabetes occurs in 5 to 9 percent of pregnancies in the United States and is growing in prevalence. It is a controversial entity, with conflicting guidelines and treatment protocols. Recent studies show that diagnosis and management of this disorder have beneficial effects on maternal and neonatal outcomes, including reduced rates of shoulder dystocia, fractures, nerve palsies, and neonatal hypoglycemia. Diagnosis is made using a sequential model of universal screening with a 50-g one-hour glucose challenge test, followed by a diagnostic 100-g three-hour oral glucose tolerance test for women with a positive screening test. Treatment consists of glucose monitoring, dietary modification, exercise, and, when necessary, pharmacotherapy to maintain euglycemia. Insulin therapy is the mainstay of treatment, although glyburide and metformin may become more widely used. In women receiving pharmacotherapy, antenatal testing with nonstress tests and amniotic fluid indices beginning in the third trimester is generally used to monitor fetal well-being. The method and timing of delivery are controversial. Women with gestational diabetes are at high risk of subsequent development of type 2 diabetes. Lifestyle modification should therefore be encouraged, along with regular screening for diabetes. Evidence for screening, diagnosing, and managing gestational diabetes mellitus has continued to accrue over the past several years. In 2003, the U.S. Preventive Services Task Force1 (USPSTF) and the Cochrane Collaboration2 found insufficient evidence to recommend for or against screening for or treating gestational diabetes. However, a subsequent randomized controlled trial (RCT) found that screening and intervention for gestational diabetes were beneficial.3 Nonetheless, in 2008, Continue reading >>

Gestational Diabetes

Gestational Diabetes

Gestational diabetes is a condition in which your blood sugar levels become high duringpregnancy. It affects up to 10% of women who are pregnant in the U.S. each year. There are two classes of gestational diabetes . Women with class A1 can manage it through diet and exercise. Those who have class A2 need to take insulin or other medications. Gestational diabetes goes away after you give birth . But it can affect your babys health, and it raises your risk of getting type 2 diabetes later in life. You can take steps so you and your baby stay healthy. Women with gestational diabetes dont usually have symptoms or may chalk them up to pregnancy. Most find out that they have it during a routinescreening. When you eat, your pancreas releases insulin, a hormone that helps move a sugar called glucose from your blood to your cells, which use it for energy. During pregnancy, your placenta makes hormones that cause glucose to build up in your blood . Usually, your pancreas can send out enough insulin to handle it. But if your body cant make enough insulin or stops using insulin like it should, your blood sugar levels rise, and you get gestational diabetes . Youre more likely to get gestational diabetes if you: Are African-American, Asian, Hispanic, or Native American Have blood sugar levels that are higher than they should be but not high enough to be diabetes (this is called prediabetes) Have high blood pressure or other medical complications Have given birth to a large baby (weighing more than 9 pounds) Have given birth to a baby who was stillborn or had certain birth defects Gestational diabetes usually happens in the second half of pregnancy. Your doctor will check for it between weeks 24 and 28 or sooner if you're at high risk. Your doctor will give you a glucose challenge or Continue reading >>

Diagnosis

Diagnosis

Print Medical experts haven't agreed on a single set of screening guidelines for gestational diabetes. Some question whether gestational diabetes screening is needed if you're younger than 25 and have no risk factors. Others say that screening all pregnant women is the best way to identify all cases of gestational diabetes. When to screen Your doctor will likely evaluate your risk factors for gestational diabetes early in your pregnancy. If you're at high risk of gestational diabetes — for example, your body mass index (BMI) before pregnancy was 30 or higher or you have a mother, father, sibling or child with diabetes — your doctor may test for diabetes at your first prenatal visit. If you're at average risk of gestational diabetes, you'll likely have a screening test during your second trimester — between 24 and 28 weeks of pregnancy. Routine screening for gestational diabetes Initial glucose challenge test. You'll drink a syrupy glucose solution. One hour later, you'll have a blood test to measure your blood sugar level. A blood sugar level below 130 to 140 milligrams per deciliter (mg/dL), or 7.2 to 7.8 millimoles per liter (mmol/L), is usually considered normal on a glucose challenge test, although this may vary by clinic or lab. If your blood sugar level is higher than normal, it only means you have a higher risk of gestational diabetes. You'll need a glucose tolerance test to determine if you have the condition. Follow-up glucose tolerance testing. You'll fast overnight, then have your blood sugar level measured. Then you'll drink another sweet solution — this one containing a higher concentration of glucose — and your blood sugar level will be checked every hour for three hours. If at least two of the blood sugar readings are higher than normal, you'll Continue reading >>

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